The following work builds upon the subject matter disclosed in an earlier filed U.S. application, Ser. No. 07/542,752, currently pending, which is incorporated herein by reference. That earlier and more comprehensive work was based upon a scheme of hierarchical diagnostic classification for patient ranking and data processing. It generally dealt with a computer-based tracking and monitoring system for the retrospective analysis of patient care results, physician performance and clinical resource management in a primary care out-patient environment. In this earlier work, specific programs were designed to mimic common aspects of out-patient clinical medicine, and specifically allowed for the detection and compilation of unjustified (overuse) office visits, both scheduled and unscheduled, according to a set of computer program specified criterion, the tracking the nature of patient care during protracted episodes of out-patient illnesses at varying levels of clinical severity, the identifying of unnecessary lab work during unremarkable office visits, the monitoring of impending or actual medication induced toxicity, the medication and physical data on cardiac patients during serious symptoms, etc.
In the prior work, the bulk of the pool of clinical data which was used in processing originated from the primary care out-patient visit, both scheduled and unscheduled. Such data included treatment modalities (medication), physical data observation (signs and symptoms), diagnostic tests, etc. All of these were encoded and stored logically in different, related files. Each patient's files were linked by common data fields. These records were created and loaded through prototype data entry routines.
The earlier work, however, did not address some common problems which occur in this environment. First, there is frequently disparity in time (days) between the running of two different types of tests which originate from the same lab test request, such as blood work and EKG/CXR tests. Second, lab tests are sometimes ordered in the absence of or aside from a formal encounter (or "source") office visit. The most frequent example is over the telephone from a spontaneous call by a patient (which is termed a "non-source" request). When this happens there is naturally no link between a source invoice that would normally link various lab tests together. Both problems are not mutually exclusive and are met by the present invention. Further, this invention includes a revision of the specialist record for storing more comprehensive data.